Today’s news that the Better Care project, to merge health and social care in the community has failed to deliver any benefits comes as no surprise to me.
Let me first say I do not have first hand experience in this exact area but I do have experience in local authorities and in business case writing.
I don’t know where the problem lies, but I suspect it is one of the following:
- It’s too early to tell. The project was supposed to deliver £500 million of benefits in the first year. How was that calculated? Were the benefits phased in? Very few projects deliver in their first year. It might just need longer to bed in.
- Were the benefits realistic? I have seen government business cases before, justified by quite ridiculous claims of the benefits that would be realised. The benefits need to be logged, scrutinized and then realistically reduced (even a fantastically successful project would be lucky to realise even 70% of it’s benefits claimed).
- I have lost count of the number of government initiatives I’ve witnessed where I can only assume that the MP’s that come up with the schemes have no idea how they will be implemented at ground level. This scheme like so many others has no doubt brought in a whole new level of management, data recording, analysis and control that is extremely costly. They will have no doubt spent incredible sums just tying up the IT systems of social care and health. Did the business case counter the proposed benefits with the actual costs of delivery?
- Or perhaps the whole system was not looked at holistically. Trying to improve one part of a complex interconnected process merely squeezes the issues elsewhere.
Or perhaps it was all of these.
Until the public sector, government and local authorities start being realistic in their business cases and benefits realisation, then big projects are going to fail.